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College Health Nursing  College Health Nursing is a unique body of knowledge, skills and competencies that has its roots in pediatrics, adolescent medicine, community health, primary care, health education and promotion.  No one standard fits college health!  In 1973, the American Nurses Association published “Standards of Nursing Practice”.  In 1986, ANA published “Standards of College Health Nursing Practice”.

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College Health Nursing  Thanks to the founding mothers of ACHA, a task force of members: Ruth Reagan Hutchinson, Mary Judith Garner, Mary Kate Hefferen, Luana Villalobos Joslin, and Connie Critchfelld joined together under the direction of the Council of Community Health Nurses of ANA and developed Guidelines for College Health Nursing Practice.  These guidelines became the basis for standards of the performance of nursing care that applies to our practice as nurses in any college setting.

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College Health Nursing  ANA stated: this document is consistent with the purpose of college health nursing to enhance the educational process by modifying or removing health related barriers to learning, and by promoting an optimal level of wellness and self-care. The standards are based on a nursing model oriented to the client’s wellness and self-care. For purposes of this document, health is viewed as more than the absence of illness.

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College Health Nursing  It is the positive state of full functioning in relations to one’s capacities and life-style. Each individual’s state of health and life-style must be understood with the context of the individual’s circumstances, family, community, and culture.  Based on the above philosophy, how do college health nurses and NP’s actually practice?  Everyone wants that answer?

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How this workshop began: ACHA List Mates: “Does anyone have any nursing protocols they could share?”

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Idea  November 16, 2011  Reply: “I have been watching the conversation on the nursing protocols go back and forth and see that there appears to be some interest in the gathering of information that would be useful to many others. Would this be something you all would consider doing as part of the nurse-directed section of ACHA? This would be a wonderful way to collaborate and utilize all types of tools to create. Just a thought!”

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What is a Nursing Protocol?  A nursing protocol is considered to be a set of predetermined criteria that define appropriate nursing interventions that articulate or describe situations in which the nurse makes judgments relative to a course of action for effective management of common patient care problems.

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What is the Medical Providers’ Role?  Understand scope and standards of nursing practice.  Varies state to state and RN vs LPN vs CMA  Embrace nursing role in college health.  Different than many other healthcare settings  Need a provider “leader”(an ally to the nurses)  Collaborate  Be willing to change  Educate, Encourage, Provide Feedback, and Be Patient!  Remember we are a healthcare “team”!

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How will providers benefit?  Don’t they get tired of seeing hangnails and paper cuts?  What better way to see more patients, more efficiently!  Happier nurse co-workers!

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How will the nurses benefit?  Greater job satisfaction  Utilize skills  Learned in nursing school  Used for so many years in other jobs  Nurse recruiting tool?  Not just another “clinic” job.

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Most importantly: How will the patients benefit?  More efficient care  More appropriate care  More appointments available for “sick” patients  Care provided by happier providers and nurses who are using their skills to the fullest level of training  Greater patient satisfaction!

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What can an RN really do? Nothing more than vitals & PMH, right? Nursing Process means: 1. assessing human responses to actual or potential health conditions; 2. establishing nursing diagnoses; 3. establishing a plan of care for the client/patient, including goals, outcomes, and prescriptions for nursing interventions; 4. implementing the plan of care through the direct and indirect provision of nursing interventions; and 5. evaluating client/patient responses to the plan of care and nursing interventions, and making adjustments to the plan of care based upon such evaluation. NEBRASKA HEALTH AND HUMAN SERVICES REGULATION AND LICENSURE 172 NAC 99 WRONG

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Protocol Approval  Medical provider resources will vary from school to school.  Prove to the medical providers that you have the nursing skills necessary.  Develop a plan for periodic review.  Frequency and format will depend upon your situation.  Do they still not buy into your plan?  Suggest they talk to colleagues at other college health centers who are utilizing nurses.  Share information learned today.  Remind them that nurses can make their lives easier.

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Working Group Objectives  Initiate a sustainable effort toward the development of college health specific nursing protocols.  Identify at least one diagnosis/condition around which to create a protocol.  Within the work group, develop the protocol according to the attached template.  Present the completed protocol(s) to the general group.

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Scope of Nursing Practice  Original Standards of College Health Nursing Practice published by the American Nurses Association (ANA) in 1986  A second ANA publication, A Statement on the Scope of College Health Nursing Practice, was released in 1990  Practice parameters for all levels of nursing, practical, registered professional, and advanced, are determined by State Boards of Nursing